| NPI | 1770927618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.012069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012069) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 34.012069) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-06-02 |